A Westcountry GP-turned-MP has warned access to doctors' surgeries in rural areas could be reduced under plans announced by David Cameron for them to be open seven days a week.Former Dartmoor GP Sarah Wollaston, the Conservative MP for Totnes, has warned the "workforce crisis" in primary care will make it difficult for countryside practices to be open all hours.The Prime Minister today announced a £50 million trial to encourage longer opening hours, which will include nine pilot projects in areas across England, to ease pressure on stretched A&E departments.Dr Wollaston, a family doctor until elected to Parliament in 2010, supports a seven-day GP service. But she is concerned that the goal will be impossible to achieve without more GPs and nurses.Speaking to the Western Morning News at the Conservative Party conference in Manchester, she said she was worried the plan would fail if politicians are "dictating how GPs have to do it".And Dr Wollaston said rural towns and villages risked getting less access to doctors if the pilot seven-day services attracted doctors to urban areas.She went on to argue small practices could struggle to stay open at weekends in any case – whereas larger city practices could adapt.One reason is because rural GPs could not join forces with other practices because of difficulties over sharing patient records.She said: "You could make access to GPs worse in some parts of the country by putting money into pilots in urban areas. The question is are we going to make it even more difficult to recruit GPs in rural areas."The danger is we raise expectations that this will be the magic bullet for GP access. But that won't happen unless you address the problem of the workforce crisis."If you have a small practice in rural Devon with only two doctors, how are you going to be able to roll this model out? It could be different if you have a large practice. If you have six doctors you might be able to come up with a solution."Dr Wollaston – who has not seen or been consulted on the plan – said she was disappointed people with "lived experience and expertise" had been excluded from formulating the policy, and argued against "top down" Whitehall edicts driving the implementation.Under the scheme, the extra cash is being offered to groups of GPs proposing the most effective ways to improve access.As well as extended surgery hours, ministers hope they will pioneer more effective use of technology – such as carrying out consultations with patients via video calls, email and phone.Electronic prescriptions, online appointment booking and allowing people to visit a number of different surgeries across an area are also measures being sought from the first wave.Mr Cameron said: "Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life."We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week."We also want greater flexibility, so people can speak to their family doctor on the phone, send them an email or even speak to them on Skype."The first pilot projects are due to be operating by April 2014 with the hope they will be copied widely across the country.Officials said the 8am-8pm seven-day hours would not be a requirement for successful bids but made clear that was the expectation.Similar initiatives are already being tried in some parts of the country - including parts of Manchester, where some surgeries will move to seven-day opening.But critics say there is already a shortage of GPs because of a retirement "bulge", more female doctors working part-time to raise families and a trend for medical school graduates to seek consultant hospital jobs that do not exist rather than go into general practice.

23 comments

GPs continually tell us how naughty patients are for missing appointments and how much this costs the NHS. (I personally think that doctors secretly love missed appointments. A bit like a free period when you were at school.) Of course it doesn't cost *them* anything...they get paid according to the total number of patients on the practice books, not by how many they actually see.
So here's a tip. Next time you genuinely need attention and are told you can't get an appointment 'til the 10th of Never, just turn up (early). Park yourself in the waiting-room and say you'll take the first missed appointment available. I did it and it worked for me.
But I'm not suggesting this as a Hypochondriac's Charter. I was really very poorly and a complete stranger to my GP.

But that's a failure of the person who should have taken the ultimate responsibility for his care.
In business we always had one basic rule. . Your client is YOUR responsibility. If anything went wrong, you took full responsibility. . That sharpens minds.
In my view there is NO EXCUSE for the problems we keep hearing about in either nursing or medical care.
The Ward Sister or Doctor should take full responsibility or stop drawing their salaries.
I (we) echo your problem with KNOBS ON!!!
They now call MRSA "Hospital Pneumonia". . . GRRRRRRR!!!
We Christened it "MISERY" (to remember it) 20 YEARS AGO!!!
Methicillin-resistant Staphylococcus aureus.

Thoroughly agree about the dangers of social media. We had hundreds of years to get used to the idea of the printed word and yet new technologies are being rushed to market before we have even noticed let alone thought about the consequences - as in the recent cases of suicide following bullying on social media sites.
Also agree about the possibility of identity being compromised by data being "up there" - but in my opinion there is a balance to be struck between the risk of compromising identity - and the potential benefits of easier access to medical records within the world of health and social care.
On a personal note - my father spend a lot of time in hospital in the last few months of his life - and poor information flow was probably the biggest contributing factor in the poor quality of care he received. I won't go into detail but you are probably familiar with the usual paper trains, non-existent notes, poor communication between hospitals, departments, and professionals etc - all of these could have been avoided if staff had had access to good central data.

Again I disagree omnivore. . Once it's ALL OUT THERE IN CYBER SPACE, your identity has been compromised.
Doctoring just isn't what it used to be. You'd probably do better getting advice from a vet. The ones who get looked after best now are the hypochondriacs who book all the appointments early. . The self-employed who only go to the Doctor if they're 'dying' need to see a Doctor 'today', not in two weeks time!
IMO, only the naive use things like Facebook and Twitter.
That's now 'Half the World'.

I simply disagree. . If everyone could inspect their 'electronic records' and see what had been added about them, or was missing or inaccurate they'd be terrified.
It's the Big Brother nightmare and it spreading right across the animal world now driven by Brussels. . Of course it doesn't apply to the 'travelers' etc. because they just ignore it. . Just us law-abiding who've always known who we could trust in these matters anyway.

I am not defending poor practice or mistakes, I am saying that with an electronic care record less mistakes will occur, lives will be saved and hopefully in the long run money saved, are they not good enough reasons?
I couldn't agree more about poor commissioning, as I said to our resident clown Sidney/Whiterabbit/Griller its historical, back in the early 90's different areas and GP brought in their own systems and no one thought about making them future proof, now we have a mix of off the self and home grown programs that cannot communicate with each other and as you rightly said, every time a Govt attempts some sort of large scale IT project, it ends in abject failure!

Most GPs, as most public sector workers, are far more concerned about their own careers and their own wealth than they are about the public. GPs didn't think about patient care when they opted out of weekend and night work undet the last labour government. Yet all you hear when a public sector worker is required to adapt to change is, "the patient or the public will suffer, that is our main concern" , the usual absolute rubbish from self centred public sector workers.

Most of the big computerisations have been disastrous and go massively over budget.
They don't ever totally write completely new programs. They just add-on, patch up, and botch up old programing, complete with all the old errors and accidents just waiting to happen.
The people commissioning them with 'other people's money' rarely have any proper understanding.